医者两宜致意焉。虽然，又有气虚不能导血荣养筋脉而作麻木者，有因血虚无以荣养肌肉，以致经隧涩涩而
作麻木者，又不可专执汗、灸、针三法，当要分辨气虚、血虚、痰饮、瘀血而疗。（《原理》）
汗下不可滥施 凡治痹证，不明其理，以风门诸通套药施之者，医之罪也。痹证非不有风，然风入
在阴分，与寒湿互结，扰乱其血脉，致身中之阳不通于阴，故致痹也。古方多有用麻黄、白芷者，以麻黄能
通阳气，白芷能行营卫，然已入在四物、四君子等药之内，非颛发表明矣。至于攻里之法，
则从无有用之者，以攻里之药皆属苦寒，用之则阳愈不通，
其痹转入诸府，而成死证者多矣，可无明辨而深戒欤。（《法律》）
乌附之用 风痹之证，大抵因虚者多，因寒者多。惟血气不充，故风寒得以入之，惟阴邪留滞，故
经脉为之不利，此痛痹之大端也。惟三气饮及大防风汤之类方能奏效，凡治痹之法，惟此为最。（景岳）
凡坐卧及倚靠之久而致经络气血不通，即麻而木，可见其郁滞也。凡麻木多属四肢及手足之指者，此
则四末气血充荣不到，故多麻木也。丹溪谓此当用附子行经，则此意也。（《医统》）
乌附辛热，最能耗液者也。夫既津液不足而为麻，俗方反用乌附而愈者，得非生津养液之药为主，
而用此为佐，以导其气之滞欤。若曰独以乌附治之，决无可愈之理。（《统旨》）
治不宜燥热（吐痰） 凡病痹之人，其脉沉涩。今人论方者，见诸痹证，遽作香港脚治之，岂知《
内经》中本无香港脚之说云云。奈何治此者，不问经络，不分脏腑，不辨表里，便作干湿香港脚，乌之附之，
乳之没之，种种燥热攻之，中脘灸之，脐下烧之，三里火之，蒸之熨之，汤之炕之，以至便
旋涩滞，前后俱闷，虚燥转甚，肌肤日削，食饮不入，邪气内侵，虽遇扁华，亦难措手。若此者何哉？胸膈
间有寒痰不去故也。痹病本不死，死者医之误也。虽亦用蒸之法，必先涌去其寒痰，然后诸法皆效。（《事亲》）
治勿怠慢 大抵痹生于虚，为病多重痛沉着，不易得去，须制对症药，日夜饮之，虽留连不愈，
能守病禁，不令入脏，庶几可扶持也。昔钱仲阳为宋之一代明医，自患痛痹，取茯
苓之大如斗者，以法啖之，能移于手足，为之偏废，不能尽
去，可见其为治之难矣。（《保命歌括》）
温经和血诸方 附子汤，治风湿寒痹，骨节疼痛，皮肤不仁，肌肉重着，四肢缓纵。
附子（生去皮脐） 白芍药 桂心 甘草 白茯苓 人参（各三分） 白术（一两）
上为锉散，每服四钱，水三盏，煎七分，去滓食前服。（《三因》）（按∶此本出《千金·历节》中，
有干姜。《三因》名附子八物汤，宜参彼门。）
治五种痹，腿并臂间发作不定，此脾胃虚，卫气不温分肉，为风寒湿所着，芎附散。
小川芎 附子（炮去皮脐） 黄 （蜜炙） 白术 防风（去钗股）
当归（洗去芦薄切焙干） 熟干地黄（酒洒九蒸九曝焙秤） 桂心（不见火） 柴胡（去苗洗净） 甘草（炙，各等分）
上为粗末，每服四钱，水一盏半，生姜三片，枣一个，同煎至七分去滓，食前日三服。常服不
生壅热，兼消积冷。（《本事》）
小防风汤，治手足麻木不仁。
防风（去芦并枝者） 秦艽（去苗并土） 羌活 附子（炮去皮脐各一两）
上为粗末，每服三大钱，水一盏半，姜钱三片，煎至七分去滓，入生地
黄汁两合，再煎数沸服，空心食前。（《叶氏》）
五补丸，凡妇人遍身麻痹，谓之不仁，皆因血风，血虚受风湿所致。
黄 （一两） 人参（半两） 附子（一个） 当归（三钱） 白芍（五钱）
上为细末，炼蜜为丸，祛风散下。（《仙传济阴方》）（按∶祛风散难用，盖此方水煎为佳。）
理中汤，治寒湿痹，加附子、天麻四分之一。（《得
效》）
三气饮，治血气亏损，风寒湿三气乘虚内侵筋骨，历节痹痛之极，及痢后鹤膝风痛等证。
当归 枸杞 杜仲（各二钱） 熟地（三钱或五钱） 牛膝 茯苓 芍药（酒炒） 肉
桂（各一钱） 北细辛（或代以独活） 白芷 炙甘草（各一钱） 附子（随宜一二钱）
水二钟，加生姜三片，煎服。如气虚者，加人参、白术随宜。风寒胜者，加麻黄一、二钱。此饮亦可浸
酒，大约每药一斤，可用烧酒六七升，浸十余日，徐徐服之。（《景岳》）
三痹汤，治血气凝滞，手足拘挛，风痹气痹等疾皆疗。
川续断 杜仲（去皮切姜汁炒） 防风 桂心 细辛 人参 白茯苓 当归 白芍药 甘草（各一两） 秦
艽生地黄 川芎 川独活（各半两） 黄 川牛膝（各一两）
上 咀为末，每服五钱，水二盏，姜三片，枣一枚，煎至一盏，去滓热服，无时候，但腹稍空服。有
人病左臂不随，后已痊平，而手指不便无力，试诸药不验，服此药才半即安。（《妇人良方》）（按∶此方
即独活寄生汤，不用寄生，用续断，加黄 者，寄生汤见《腰痛》。）《心统》独活寄生汤，治风湿流于手
足，麻木疼痛。《医通》改定三痹汤，于本方去续断、杜仲、秦艽、地黄、独活、牛膝，加白术、防己、乌头（炮）。
蠲痹汤，治风湿相搏，身体烦疼，项臂痛重，举动艰难，及手足冷痹，腰腿沉重，筋脉无力。
当归（去土酒浸一宿） 羌活（去芦头） 姜黄 赤芍药 黄 （蜜炙） 防风（去芦头以上六味各一
两半） 甘草（半两炙）
上件 咀，每服半两，水二盏，生姜五片，同煎至一盏，去滓温服，不拘时候。（《杨氏》）（互见《臂痛》舒经汤
下） 《魏氏》蠲痹汤，治气弱当风饮啜，风邪客于外，饮湿停于内，风湿内外相搏，体倦舌麻，甚则恶风多
汗，头目昏眩，遍身不仁（合肥陶大渊传），于本方加白术、附子、薏苡仁。《济生》于本方去防风。
驱表初方 治行痹，行走无定，防风汤方。
防风（去叉） 甘草（炙锉各一两） 黄芩 当归（切焙） 赤茯苓（去黑皮各一两） 秦艽（去苗
土） 葛根（锉各三分） 桂（去粗皮） 杏仁（汤去皮尖双仁炒各一两） 麻黄（去根节煎掠去沫焙半两）
上一十味粗捣筛，每服五钱，酒一盏，水一盏，枣三枚掰破，生姜五片，同煎至一盏，去滓温服，日二
夜一。（《圣济》）《济生》防风汤，治血痹皮肤不仁，于本方去葛根、麻黄，加独活、芍药。
治风湿痹留着不去，四肢 麻拘挛浮肿，茯苓汤方。
赤茯苓（去黑皮） 桑根白皮（各二两） 防己 官桂（去粗皮） 芎 （各一两半） 甘草（三两） 芍
药当归（切焙） 麻黄（去根节先煮掠去沫焙干各一两半）
上九味粗捣筛，每服六钱匕，以水二盏，枣三枚掰破同煎，去滓温服，空心临卧。如欲出汗，服药了以生
姜热粥投之，汗出慎外风。（《圣济》）《宣明》茯苓川芎汤，治着痹、以防风代防己。
治热痹，升麻汤方。
升麻（三两） 茯神（去木） 人参 防风（去叉） 犀角（镑） 羚羊角（镑） 羌活（去芦
头以上各二两） 官桂（去粗皮半两）
上八味粗捣筛，每服四钱匕，水一盏半，生姜一块拍碎，竹沥少许，同煎至一盏，去滓温服，不拘时
候。（《圣济》）
五积散，寻常被风寒湿气交互为病，颈项强直，或半身偏疼，或复麻痹，但服此药，加麝香末少许煎服。（《易
简》）
薏苡仁汤，治寒湿痹痛。
当归（一两） 芍药（炒一两） 薏苡仁（一两） 麻黄（一两） 肉桂（一两） 甘草（炙一
两） 苍术（米泔浸炒一两）
上锉，每服七钱，生姜三片煎服。自汗，减麻黄。热，减桂。（《指掌》）
盐贾叶作舟，遍体疼痛，尻髀皆肿，足挛膝急。余曰∶此寒伤荣血，筋脉为之引急，《内经》所谓
痛痹也。用乌药顺气散，七剂而减。更加白术、桂枝，一月而愈。（《必读》）
疏气方 开结舒经汤，治七情六郁，气滞经络，手足麻痹。
紫苏（八分） 陈皮（八分） 香附（醋炒八分） 台乌（八分） 川芎（八分） 苍术（
米泔浸三日锉碎炒八分） 羌活（八分） 南星（八分制） 半夏（八分制） 当归（八分） 桂枝（
四分） 甘草（四分）
上锉，生姜三片，水煎，入竹沥、姜汁各半盏服。（《医鉴》）
针法 陕帅郭巨济，偏枯，二指着痹，足不能伸，迎先师治之。以长针刺委中，至深骨而不知痛，
出血一二升，其色如墨，又且缪刺之。如是者六七次，服药三月，病良愈。（《纲目》引垣）（出典
当考。按∶《寿夭刚柔篇》曰∶久痹不去身者，视其血络，尽出其血。盖东垣所本也。）
医者对此应当两方面都予以重视。虽然如此，又有因气虚不能推动血液荣养筋脉而导致麻木的，有因血虚无以荣养肌肉，致使经络隧道涩滞而产生麻木的，这些情况又不可专门执着于发汗、艾灸、针刺这三种方法，必须要分辨是气虚、血虚、痰饮还是瘀血，然后进行调理治疗。（《原理》）
发汗和攻下法不可滥用。凡是治疗痹证，如果不明白其道理，随意使用风门诸通套药方进行治疗，这是医者的过错。痹证并非没有风邪，然而风邪侵入阴分，与寒湿相互结聚，扰乱血脉，导致人体中的阳气不能通达于阴分，因此造成痹证。古方中多有使用麻黄、白芷的，因为麻黄能通达阳气，白芷能运行营卫之气，但这些药物已经包含在四物汤、四君子汤等方剂之内，显然不是专门用于发表（发散表邪）。至于攻里的治法，则从未有用过的，因为攻里的药物都属于苦寒性质，使用它们会使阳气更加不通畅，导致痹证转入各个脏腑，从而形成死证的很多，难道可以不加以明辨并深深引以为戒吗？（《法律》）
乌头、附子的使用。风痹之证，大多是因为虚损所致，大多是因为寒邪所致。只有气血不充盈，所以风寒得以侵入；只有阴邪留滞，所以经脉为之不利，这是痛痹的大致机理。只有三气饮及大防风汤之类的方剂才能奏效，凡是治疗痹证的方法，以此最为优越。（景岳）
凡是久坐、久卧以及倚靠时间过长导致经络气血不通，就会感到麻而木，可见这是郁滞的表现。凡是麻木多属于四肢及手足手指部位的，这是因为四肢末端的气血充盛荣润不到达，所以容易麻木。丹溪说这种情况应当用附子来通行经脉，就是这个意思。（《医统》）
乌头、附子性味辛热，最易耗伤津液。既然因为津液不足而出现麻木，世俗方剂反而使用乌头、附子而治愈的，岂不是以生津养液的药物为主，而将乌附作为辅助，用来引导气的滞涩吗？如果说单独用乌附来治疗，绝对没有治愈的道理。（《统旨》）
治疗不宜使用燥热之法（吐痰）。凡是患有痹病的人，其脉象沉涩。现在讨论方剂的人，见到各种痹证，就匆忙当作香港脚（足痛风/痹症）来治疗，哪里知道《内经》中本来就没有香港脚的说法等等。奈何治疗此病的人，不问经络，不分脏腑，不辨表里，便当作干湿香港脚，使用乌头、附子，乳香、没药，种种燥热药物攻伐，在中脘穴施灸，在脐下烧灼，在足三里穴用火疗，熏蒸熨烫，汤洗炕烤，以至于二便涩滞不畅，前后俱感闷塞，虚燥症状转甚，肌肤日渐消瘦，饮食无法进入，邪气内侵，即使遇到扁鹊、华佗再世，也难以措手。像这种情况为什么呢？是因为胸膈间有寒痰未能去除的缘故。痹病本身不会致死，致死的是医生的误治。虽然也使用蒸法，但必须先涌吐去除寒痰，然后其他方法才有效。（《事亲》）
治疗勿怠慢。大抵痹证生于虚损，发病多重痛且沉着，不易祛除，必须配制对症的药物，日夜服用，即使病情迁延不愈，若能遵守病禁，不让病邪入脏，或许还可以扶持维持。从前钱仲阳是宋代的一代名医，自己患上痛痹，取茯苓大如斗者，依法食用，能将病邪转移至手足，导致半身偏废，不能完全去除，可见其治疗的困难了。（《保命歌括》）
温经和血诸方：附子汤，治疗风湿寒痹，骨节疼痛，皮肤感觉迟钝，肌肉沉重着着，四肢弛缓纵弱。
附子（生，去皮脐） 白芍药 桂心 甘草 白茯苓 人参（各三分） 白术（一两）
以上药材锉散，每次服用四钱，水三盏，煎至七分，去渣，饭前服用。（《三因》）（按：此方本出自《千金·历节》，中有干姜。《三因》名为附子八物汤，宜参考彼处。）
治疗五种痹证，腿部及手臂间发作不定，此为脾胃虚弱，卫气不能温煦分肉，为风寒湿所附着，用芎附散。
小川芎 附子（炮制，去皮脐） 黄芪（蜜炙） 白术 防风（去钗股）
当归（洗去芦头，薄切焙干） 熟干地黄（酒洒九蒸九晒焙干秤量） 桂心（不见火） 柴胡（去苗洗净） 甘草（炙，各等分）
以上为粗末，每次服用四钱，水一盏半，生姜三片，枣一个，同煎至七分去渣，饭前每日三次服用。常服不生壅热，兼消积冷。（《本事》）
小防风汤，治疗手足麻木不仁。
防风（去芦并枝者） 秦艽（去苗并土） 羌活 附子（炮制，去皮脐各一两）
以上为粗末，每次服用三大钱，水一盏半，姜钱三片，煎至七分去渣，加入生地黄汁两合，再煎数沸服用，空腹饭前服用。（《叶氏》）
五补丸，凡是妇人遍身麻痹，称为不仁，皆因血风，血虚受风湿所致。
黄芪（一两） 人参（半两） 附子（一个） 当归（三钱） 白芍（五钱）
以上为细末，炼蜜为丸，祛风散下。（《仙传济阴方》）（按：祛风散难用，大概此方用水煎煮为佳。）
三气饮，治疗血气亏损，风寒湿三气乘虚内侵筋骨，历节痹痛之极，及痢后鹤膝风痛等证。
当归 枸杞 杜仲（各二钱） 熟地（三钱或五钱） 牛膝 茯苓 芍药（酒炒） 肉桂（各一钱） 北细辛（或代以独活） 白芷 炙甘草（各一钱） 附子（随宜一二钱）
水二钟，加生姜三片，煎服。如气虚者，加人参、白术随宜。风寒胜者，加麻黄一、二钱。此饮亦可浸酒，大约每药一斤，可用烧酒六七升，浸十余日，徐徐服之。（《景岳》）
三痹汤，治疗血气凝滞，手足拘挛，风痹气痹等疾皆疗。
川续断 杜仲（去皮切姜汁炒） 防风 桂心 细辛 人参 白茯苓 当归 白芍药 甘草（各一两） 秦艽 生地黄 川芎 川独活（各半两） 黄芪 川牛膝（各一两）
以上切碎为末，每次服用五钱，水二盏，姜三片，枣一枚，煎至一盏，去渣热服，无固定时候，只要腹部稍空时服用。有人患左臂不遂，后来已痊愈，但手指不便无力，试诸药无效，服用此药才半剂即安。（《妇人良方》）（按：此方即独活寄生汤，不用寄生，用续断，加黄芪者，寄生汤见《腰痛》。）《心统》独活寄生汤，治疗风湿流于手足，麻木疼痛。《医通》改定三痹汤，于本方去续断、杜仲、秦艽、地黄、独活、牛膝，加白术、防己、乌头（炮制）。
蠲痹汤，治疗风湿相搏，身体烦疼，项臂痛重，举动艰难，及手足冷痹，腰腿沉重，筋脉无力。
当归（去土酒浸一宿） 羌活（去芦头） 姜黄 赤芍药 黄芪（蜜炙） 防风（去芦头以上六味各一两半） 甘草（半两炙）
以上切碎，每次服用半两，水二盏，生姜五片，同煎至一盏，去渣温服，不拘时候。（《杨氏》）（互见《臂痛》舒经汤下） 《魏氏》蠲痹汤，治疗气弱当风饮啜，风邪客于外，饮湿停于内，风湿内外相搏，体倦舌麻，甚则恶风多汗，头目昏眩，遍身不仁（合肥陶大渊传），于本方加白术、附子、薏苡仁。《济生》于本方去防风。
驱表初方 治疗行痹，行走无定，防风汤方。
防风（去叉） 甘草（炙锉各一两） 黄芩 当归（切焙） 赤茯苓（去黑皮各一两） 秦艽（去苗土） 葛根（锉各三分） 桂（去粗皮） 杏仁（汤去皮尖双仁炒各一两） 麻黄（去根节煎掠去沫焙半两）
以上十味粗捣筛，每次服用五钱，酒一盏，水一盏，枣三枚掰破，生姜五片，同煎至一盏，去渣温服，日二次夜一次。（《圣济》）《济生》防风汤，治疗血痹皮肤不仁，于本方去葛根、麻黄，加独活、芍药。
治疗风湿痹留着不去，四肢麻木拘挛浮肿，茯苓汤方。
赤茯苓（去黑皮） 桑根白皮（各二两） 防己 官桂（去粗皮） 川芎（各一两半） 甘草（三两） 芍药 当归（切焙） 麻黄（去根节先煮掠去沫焙干各一两半）
以上九味粗捣筛，每次服用六钱匕，以水二盏，枣三枚掰破同煎，去渣温服，空腹临卧。如欲出汗，服药后以生姜热粥投之，汗出慎外风。（《圣济》）《宣明》茯苓川芎汤，治疗着痹，以防风代防己。
治疗热痹，升麻汤方。
升麻（三两） 茯神（去木） 人参 防风（去叉） 犀角（镑） 羚羊角（镑） 羌活（去芦头以上各二两） 官桂（去粗皮半两）
以上八味粗捣筛，每次服用四钱匕，水一盏半，生姜一块拍碎，竹沥少许，同煎至一盏，去渣温服，不拘时候。（《圣济》）
五积散，寻常被风寒湿气交互为病，颈项强直，或半身偏疼，或复麻痹，但服此药，加麝香末少许煎服。（《易简》）
薏苡仁汤，治疗寒湿痹痛。
当归（一两） 芍药（炒一两） 薏苡仁（一两） 麻黄（一两） 肉桂（一两） 甘草（炙一两） 苍术（米泔浸炒一两）
以上锉，每次服用七钱，生姜三片煎服。自汗，减麻黄。热，减桂。（《指掌》）
盐贾叶作舟，遍体疼痛，尻髀皆肿，足挛膝急。我说：这是寒伤荣血，筋脉为之引急，《内经》所谓痛痹也。用乌药顺气散，七剂而减轻。更加白术、桂枝，一月而愈。（《必读》）
疏气方 开结舒经汤，治疗七情六郁，气滞经络，手足麻痹。
紫苏（八分） 陈皮（八分） 香附（醋炒八分） 台乌（八分） 川芎（八分） 苍术（米泔浸三日锉碎炒八分） 羌活（八分） 南星（八分制） 半夏（八分制） 当归（八分） 桂枝（四分） 甘草（四分）
以上锉，生姜三片，水煎，入竹沥、姜汁各半盏服。（《医鉴》）
针法 陕帅郭巨济，偏枯，二指着痹，足不能伸，迎先师治之。以长针刺委中，至深骨而不知痛，出血一二升，其色如墨，又且缪刺之。如是者六七次，服药三月，病良愈。（《纲目》引垣）（出典当考。按：《寿夭刚柔篇》曰：久痹不去身者，视其血络，尽出其血。盖东垣所本也。）
Physicians should pay attention to both aspects. Nevertheless, there are cases of numbness caused by Qi deficiency failing to guide blood to nourish the sinews and vessels; and cases where Blood deficiency fails to nourish the muscles, leading to sluggishness in the meridians and collaterals, resulting in numbness. In such cases, one must not exclusively rely on sweating, moxibustion, or acupuncture methods. It is essential to differentiate between Qi deficiency, Blood deficiency, phlegm-fluid retention, and blood stasis before treating. (Principles)
Sweating and purging methods should not be applied indiscriminately. In treating Bi syndrome (Obstruction Syndrome), if one does not understand its principles and applies generic wind-dispelling remedies, it is the physician's fault. Although Wind may be present in Bi syndrome, when Wind enters the Yin aspect and binds with Cold-Dampness, it disrupts the blood vessels, preventing Yang Qi from penetrating into the Yin, thus causing Bi syndrome. Ancient formulas often used Ephedrae Herba (Mahuang, 麻黄) and Angelicae Dahuricae Radix (Baizhi, 白芷); since Ephedrae Herba can unblock Yang Qi and Angelicae Dahuricae Radix can circulate Ying and Wei Qi, these herbs were already included within formulas like Si Wu Tang (Four Substances Decoction) and Si Jun Zi Tang (Four Gentlemen Decoction), clearly indicating they were not used solely for releasing the exterior. As for interior-purging methods, they have never been used, because interior-purging drugs are all bitter and cold in nature; using them would further obstruct Yang Qi, leading to Bi syndrome transferring into the Zang-Fu organs, resulting in many fatal cases. Should we not distinguish this clearly and take deep warning? (Legal Principles)
The use of Aconite Root (Wutou, 乌头) and Prepared Aconite Root (Fuzi, 附子). Wind-Bi syndromes are mostly due to deficiency and Cold. Only when Qi and Blood are insufficient can Wind-Cold invade; only when Yin pathogenic factors remain stagnant do the meridians become unfavorable. This is the main mechanism of Painful Bi syndrome. Only formulas such as San Qi Yin (Three Qi Drink) and Da Fang Feng Tang (Major Saposhnikovia Decoction) can achieve efficacy. Among all methods for treating Bi syndrome, these are the best. (Jingyue)
Prolonged sitting, lying down, or leaning causes obstruction of Qi and Blood in the meridians, leading to numbness and insensibility, revealing stagnation. Numbness mostly occurs in the four limbs and fingers/toes because the Qi and Blood at the extremities fail to reach and nourish them adequately. Danxi stated that Aconite Root (Fuzi, 附子) should be used to unblock the meridians in such cases, which reflects this idea. (Medical Compilation)
Aconite Root (Wutou, 乌头) and Prepared Aconite Root (Fuzi, 附子) are acrid and hot, most prone to consuming body fluids. If numbness arises from insufficient fluids, yet folk prescriptions cure it by using Wutou and Fuzi, is it not because fluid-nourishing herbs serve as the principal agents, while Wutou and Fuzi act as assistants to guide the stagnation of Qi? To claim that Wutou and Fuzi alone can cure it is absolutely without reason. (Summary of Principles)
Treatment should avoid excessive dryness and heat (Expectoration). Patients with Bi syndrome typically present with a deep and choppy pulse. Modern practitioners, upon seeing various Bi syndromes, hastily treat them as Hong Kong Foot (Gout/Bi syndrome), unaware that the *Neijing* contains no concept of "Hong Kong Foot." Why do physicians treating this condition ignore the meridians, fail to distinguish Zang-Fu organs, neglect superficial/deep differentiation, and treat it as Dry or Damp Hong Kong Foot? They employ Aconite Root (Wutou, 乌头) and Prepared Aconite Root (Fuzi, 附子), Frankincense (Ruxiang, 乳香) and Myrrh (Moyao, 没药), and other drying-hot attacking methods. They apply moxibustion to Zhongwan (CV12), cauterize below the umbilicus, apply fire therapy to Zusanli (ST36), steam, iron, wash, and bake. This leads to difficult urination and defecation, fullness in the chest and abdomen, worsening deficiency and dryness, emaciation, inability to eat, internal invasion of pathogens, and even if Bian Que or Hua Tuo were alive, they would find it hard to handle. What is the cause? The presence of Cold-Phlegm in the chest and diaphragm that has not been removed. Bi syndrome itself is not fatal; death results from medical error. Although steaming methods are used, Cold-Phlegm must first be expelled via vomiting before other methods can be effective. (Experience in Medicine)
Do not neglect treatment. Generally, Bi syndrome arises from deficiency, manifests as heavy, fixed pain, and is difficult to eliminate. One must prepare targeted medicines to be taken day and night. Even if the disease lingers, if one adheres to dietary and lifestyle restrictions and prevents the pathogen from entering the Zang organs, recovery may be supported. Formerly, Qian Zhongyang, a renowned physician of the Song Dynasty, suffered from Painful Bi. He consumed large amounts of Poria Cocos (Fuling, 茯苓) according to specific methods, which shifted the pathogen to his limbs, causing hemiplegia, though it could not be completely eliminated. This demonstrates the difficulty of treatment. (Song of Preserving Life)
Formulas for Warming Meridians and Harmonizing Blood:
Fuzi Tang (Aconite Decoction), treats Wind-Cold-Damp Bi, bone and joint pain, skin insensibility, heavy muscles, and flaccidity of the four limbs.
Prepared Aconite Root (Raw, peeled, navel removed), White Peony Root, Cassia Twig, Licorice Root, Poria Cocos, Ginseng Root (each 3 fen), Atractylodes Macrocephala Rhizome (1 liang).
Crush into coarse powder. Take 4 qian per dose, decoct in 3 cups of water until reduced to 0.7 cup, strain, and take before meals. (Three Causes) [Note: This originates from *Qianjin Jiyi* under "Lijie", containing Dried Ginger. *San Yin* names it Fuzi Bawu Tang.]
Xiong Fu San (Cyperi and Aconite Powder), treats five types of Bi syndrome with intermittent attacks in legs and arms, caused by Spleen-Stomach deficiency, Wei Qi failing to warm the muscle spaces, and attachment of Wind-Cold-Dampness.
Sichuan Lovage Rhizome, Prepared Aconite Root (peeled, navel removed), Astragalus Root (honey-fried), Atractylodes Macrocephala Rhizome, Saposhnikovia Root (remove wire-like roots), Angelica Sinensis Radix (washed, rhizome removed, thinly sliced, dried), Prepared Rehmannia Root (sprinkled with wine, steamed nine times, sun-dried nine times), Cassia Twig (avoid direct fire), Bupleurum Root (remove seedlings, washed), Licorice Root (roasted, equal parts).
Make into coarse powder. Take 4 qian per dose with 1.5 cups of water, 3 slices of fresh ginger, and one jujube. Decoct to 0.7 cup, strain, and take three times daily before meals. Regular use prevents heat accumulation and resolves accumulated cold. (Essential Cases)
Xiao Fang Feng Tang (Minor Saposhnikovia Decoction), treats numbness and insensibility of hands and feet.
Saposhnikovia Root (remove rhizome and branches), Gentian Root (remove seedlings and soil), Notopterygium Rhizome, Prepared Aconite Root (peeled, navel removed, each 1 liang).
Make into coarse powder. Take 3 da qian per dose with 1.5 cups of water and 3 slices of ginger. Decoct to 0.7 cup, strain, add 2 he of fresh Rehmannia Juice, boil briefly, and take on an empty stomach before meals. (Ye Shi)
Wu Bu Wan (Five Tonics Pill), treats generalized numbness in women, called "insensibility," caused by Blood-Wind and Blood deficiency with Wind-Damp invasion.
Astragalus Root (1 liang), Ginseng Root (half liang), Aconite Root (one piece), Angelica Sinensis Radix (3 qian), White Peony Root (5 qian).
Make into fine powder, form pills with refined honey, and administer to dispel wind. (Immortal Transmitted Gynecological Formulas) [Note: Qu Feng San is difficult to use; decoction is better for this formula.]
Li Zhong Tang (Regulate the Middle Decoction), treats Cold-Damp Bi. Add one-quarter amount of Prepared Aconite Root and Gastrodia Rhizome. (Effectiveness Achieved)
San Qi Yin (Three Qi Drink), treats Bi syndrome of extreme severity in joints (Lijie) due to Wind-Cold-Damp invading bones and sinews through deficiency, accompanied by blood and Qi depletion, and post-dysentery crane-knee wind pain.
Angelica Sinensis Radix, Goji Berry, Eucommia Bark (each 2 qian), Prepared Rehmannia Root (3 or 5 qian), Achyranthes Root, Poria Cocos, Peony Root (wine-fried), Cinnamon Bark (each 1 qian), Northern Asarum Root (or substitute with Notopterygium Rhizome), Angelicae Dahuricae Radix, Roasted Licorice Root (each 1 qian), Prepared Aconite Root (1-2 qian as needed).
Decoct 2 zhong of water with 3 slices of fresh ginger. For Qi deficiency, add Ginseng Root and Atractylodes Macrocephala Rhizome as needed. For severe Wind-Cold, add Ephedrae Herba (1-2 qian). This drink can also be infused in liquor (approx. 1 jin of herbs in 6-7 sheng of distilled spirit, steeped for over 10 days, taken slowly). (Jingyue)
San Bi Tang (Three Bi Decoction), treats stagnation of blood and Qi, spasms of hands and feet, and cures Wind-Bi and Qi-Bi diseases.
Dipsacus Root, Eucommia Bark (peeled, cut, fried in ginger juice), Saposhnikovia Root, Cassia Twig, Asarum Root, Ginseng Root, Poria Cocos, Angelica Sinensis Radix, White Peony Root, Licorice Root (each 1 liang), Gentian Root, Rehmannia Root, Sichuan Lovage Rhizome, Notopterygium Rhizome (each half liang), Astragalus Root, Achyranthes Root (each 1 liang).
Chop into pieces, make into powder. Take 5 qian per dose with 2 cups of water, 3 slices of ginger, and one jujube. Decoct to 1 cup, strain, and take hot. No fixed time, but take when the stomach is slightly empty. A patient with left arm paralysis recovered but had weak fingers; other medicines failed, but half a dose of this brought relief. (Good Advice for Women) [Note: This is essentially Duhuo Jisheng Tang, replacing Sangjisheng with Dipsacus Root and adding Astragalus Root. See "Lower Back Pain" for Duhuo Jisheng Tang.] *Xintong* modified San Bi Tang by removing Dipsacus Root, Eucommia Bark, Gentian Root, Rehmannia Root, Notopterygium Rhizome, and Achyranthes Root, adding Atractylodes Macrocephala Rhizome, Stephania Root, and Processed Aconite Root.
Juan Bi Tang (Expel Bi Decoction), treats Wind-Damp binding, general body pain, heaviness of neck and arms, difficulty moving, cold Bi of hands and feet, heaviness of waist and legs, and weakness of sinews and vessels.
Angelica Sinensis Radix (soaked in wine overnight), Notopterygium Rhizome, Turmeric Rhizome, Red Peony Root, Astragalus Root (honey-fried), Saposhnikovia Root (each 1.5 liang above six flavors), Licorice Root (half liang roasted).
Chop into pieces. Take half liang per dose with 2 cups of water and 5 slices of ginger. Decoct to 1 cup, strain, and take warm. No fixed time. (Yang Shi) [See Shu Jing Tang under "Arm Pain".] *Wei Shi* Juan Bi Tang adds Atractylodes Macrocephala Rhizome, Prepared Aconite Root, and Coix Seed for cases of Qi weakness, wind exposure, internal damp-phlegm, fatigue, tongue numbness, aversion to wind, sweating, dizziness, and generalized insensibility. *Jisheng* removes Saposhnikovia Root from this formula.
Qu Biao Chu Fang (Initial Exterior-Expelling Formula) / Fangfeng Tang (Saposhnikovia Decoction), treats Xing Bi (Wandering Bi) with migrating pain.
Saposhnikovia Root, Roasted Licorice Root (each 1 liang), Scutellaria Root, Angelica Sinensis Radix (cut and dried), Red Poria Cocos (each 1 liang), Gentian Root, Kudzu Root (each 3 fen), Cinnamon Bark, Apricot Seed (blanched, peeled, double-kernel, fried, each 1 liang), Ephedrae Herba (root tips removed, boiled, scum skimmed, dried, half liang).
Ten ingredients coarsely crushed. Take 5 qian per dose with 1 cup of wine, 1 cup of water, 3 broken jujubes, and 5 slices of ginger. Decoct to 1 cup, strain, and take warm. Twice daily, once at night. (Shengji) *Jisheng* Fangfeng Tang treats Blood Bi with skin insensibility; remove Kudzu Root and Ephedrae Herba, add Notopterygium Rhizome and Peony Root.
Fuling Tang (Poria Decoction), treats Wind-Damp Bi lingering, numbness, spasms, and edema of four limbs.
Red Poria Cocos, Mulberry Root Bark (each 2 liang), Stephania Root, Official Cinnamon Bark (each 1.5 liang), Licorice Root (3 liang), Peony Root, Angelica Sinensis Radix (cut and dried), Ephedrae Herba (root tips removed, pre-boiled, scum skimmed, dried, each 1.5 liang).
Nine ingredients coarsely crushed. Take 6 qian bi per dose with 2 cups of water and 3 broken jujubes. Decoct, strain, and take warm on an empty stomach and before bed. To induce sweating, consume hot millet porridge with fresh ginger after taking the medicine. Avoid external wind after sweating. (Shengji) *Xuanming* Fuling Chuanxiong Tang treats Zhuo Bi, substituting Saposhnikovia Root for Stephania Root.
Shengma Tang (Cimicifuga Decoction), treats Re Bi (Heat Bi).
Cimicifuga Rhizome (3 liang), Poria Cocos with Hostwood, Ginseng Root, Saposhnikovia Root, Rhinoceros Horn (shaved), Antelope Horn (shaved), Notopterygium Rhizome (each 2 liang above), Official Cinnamon Bark (half liang).
Eight ingredients coarsely crushed. Take 4 qian bi per dose with 1.5 cups of water, one smashed piece of fresh ginger, and a little Bamboo Sap. Decoct to 1 cup, strain, and take warm. No fixed time. (Shengji)
Wu Ji San (Five Accumulations Powder), treats common conditions caused by interaction of Wind-Cold-Dampness, stiff neck, unilateral pain, or recurrent numbness. Take this medicine with a small amount of Musk powder. (Yijian)
Yiyi Ren Tang (Coix Seed Decoction), treats Cold-Damp Bi pain.
Angelica Sinensis Radix (1 liang), Fried Peony Root (1 liang), Coix Seed (1 liang), Ephedrae Herba (1 liang), Cinnamon Bark (1 liang), Roasted Licorice Root (1 liang), Atractylodes Rhizome (soaked in rice water, fried, 1 liang).
Chop. Take 7 qian per dose with 3 slices of ginger. Reduce Ephedrae Herba for spontaneous sweating; reduce Cinnamon Bark for heat. (Zhangzhi)
Salt merchant Ye Zuozhou suffered whole-body pain, swelling of buttocks and thighs, foot spasms, and knee stiffness. I said: This is Cold injuring Ying Blood, causing sinew contraction, known as Tong Bi (Painful Bi) in the *Neijing*. Used Wuyao Shunqi San, symptoms decreased after seven doses. Added Atractylodes Macrocephala Rhizome and Cassia Twig, cured in one month. (Bixiu)
Kaijie Shujing Tang (Unbinding and Meridian-Relaxing Decoction), treats emotional depression and Qi stagnation in meridians causing hand and foot numbness.
Perilla Leaf, Tangerine Peel, Cyperi Rhizome (vinegar-fried), Curcuma Longa Rhizome, Sichuan Lovage Rhizome, Atractylodes Rhizome (soaked in rice water 3 days, chopped, fried), Notopterygium Rhizome, Pinellia Tuber (prepared), Pinellia Ternata Tuber (prepared), Angelica Sinensis Radix, Cassia Twig, Licorice Root.
Chop, decoct with 3 slices of ginger. Add Bamboo Sap and Ginger Juice (half cup each) before taking. (Medical Mirror)
Acupuncture Method. Guo Juji, military governor of Shaanxi, suffered hemiplegia, Bi syndrome in two fingers, and inability to extend the foot. He invited my master to treat him. Using a long needle, puncture Weizhong (BL40) deeply to the bone without pain sensation, bleeding 1-2 sheng, dark as ink. Also applied Miao Ci (lateral needling). Repeated 6-7 times. After 3 months of medication, the illness was largely cured. (Compendium citing Dongyuan) [Source to be verified. Note: *Shou Yao Gang Rou Pian* states: For chronic Bi remaining in the body, observe blood collaterals and exhaust the blood. This is likely based on Dongyuan.]